In CAD, highest mortality risk for central obesity, normal BMI
Thais Coutinho, M.D., of the Mayo Clinic in Rochester, Minn., and colleagues used data for 15,547 participants with CAD in five studies from three continents to evaluate mortality risk based on measurement of both body mass index (BMI) and central obesity.
During a median follow-up of 4.7 years, the researchers identified 4,699 deaths. The worst long-term survival was observed in people of normal weight who displayed central obesity: a person with a BMI of 22 kg/m² who had a waist-to-hip ratio (WHR) of 0.98 had significantly higher mortality than a person with a similar BMI and a WHR of 0.89 (hazard ratio, 1.10); they also had significantly higher mortality than a person with a BMI of 30 kg/m² and WHR of 0.89 or 0.98 (hazard ratios, 1.61 and 1.27, respectively).
"When used alone, BMI is a misleading anthropometric measurement in patients with CAD, and although measures of central obesity predict mortality more reliably than BMI, our findings indicate that combining BMI and measures of central obesity in the assessment of mortality risk in CAD patients is superior to documenting BMI alone, and may redefine current practice," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.